Don’t you wish that you knew the answer? Don’t you wish that you had the clarity of vision to weather the bumpy times that medicine is going through? It would certainly simplify matters. Think about how sweet it would be to know when the stock market was heading up instead of down.

In many spheres of life predictions of the future are possible if we take a step back and digest what is happening in our midst. Anticipating the future of dermatology, I think, is one of those circumstances where the future can be pieced together if we just take our heads out of the sand and pool our collective wisdom. We at DW felt that this is so important that we’ve created a whole issue about the future of dermatology, even added an additional feature story, so that we can look at it from several sides. You are going to want to be sure to read each and every piece this month to learn where our colleagues think that we are heading.

You will notice that there are two pieces this month that deal with ACOs — that is not an accident. ACOs are present in many parts of the country and will be coming soon to the rest. Our legal piece provides guidance on what to ask these organizations as they approach your practices. Just the very size of some of these organizations can be intimidating. So knowing what to ask to gain a thorough understanding of the organization is critical. A leap into a swimming pool is a much better step than a leap off a gangplank. Our second piece on this topic is our feature on what dermatologists think that practices will look like in the future. The dermatologists we spoke with see groups becoming increasingly the norm, and derms focusing more and more on collaborating with others outside of dermatology. They also see the incorporation of midlevel providers into our practices as we struggle to care for a growing number of patients.

You will also want to read our piece on fee-for-service and what its future looks like. While it is popular to predict its upcoming demise, we don’t see that happening so fast. With quality reporting squarely based on the fee-for-service reimbursement model, we predict that it will remain in place for awhile. However, make no bones about it, it is changing. We anticipate that the future will have FFS reimbursement tied to quality reporting with performance and quality measures dictating the payout. Think of your local gas station. If you pay cash you get a cheaper price; those paying with credit cards encounter a financial penalty.

And lastly take note of our pieces on how technology will help us in the future. One feature is about smartphones and how they will transform all of our practices as they become even more digital. We also have a feature on the future of treatments in dermatology — it describes how diagnostics and pharmaceutical agents are becoming more and more interlaced to understand and treat disease.

Some of what we write about will please you, while some may make you uncomfortable. The bumps on the road are big ones, no mistaking it. However, the only way to succeed is to understand the options and trends, and see if we can’t work to make the future a bright one for dermatology. The only other choice we have would be to walk around wishing that magically we’ll be okay, saying, “Mirror, mirror on the wall — please don’t let dermatology take a big fall.”